Can pharmacists in North Carolina prescribe hormonal contraception?

**Yes, with training.** Pharmacists must complete required training and follow the statewide protocol for hormonal contraception.

What CPT codes can pharmacists bill in North Carolina?

In North Carolina, pharmacists can typically bill **CPT 99202, 99212** for assessment and evaluation, provided they are enrolled as a provider with NC Medicaid.

Can Pharmacists Prescribe in North Carolina? 2026 Scope of Practice Guide

Status Check: North Carolina is a Green State. Current Authority Level: New Authority (Oct 2025)

If you are a pharmacist in North Carolina, you are likely leaving revenue on the table—or practicing efficiently but dangerously.

The laws in North Carolina have changed significantly in recent years. Whether you are looking to launch a "Test and Treat" clinic or just want to legally dispense Paxlovid, you need to know exactly which protocol protects your license.

Here is the Breakdown of Pharmacist Prescribing Authority for North Carolina.

At-A-Glance: What Can You Prescribe?

Clinical Service	Authority Status	Protocol / Requirement	Billing Code
Flu/Strep Treatment	✅ YES	Statewide Standing Order	CPT 99202
Hormonal Contraception	✅ YES	Training Required	CPT 99202
HIV PrEP	✅ YES	PEP/PrEP Protocol	CPT 99212
Paxlovid (COVID-19)	✅ YES	Federal + State Authority	CPT 99212
Opioid Antagonist	✅ YES	Statewide Protocol	Product Only

1. Flu/Strep Treatment Authority

The Law: North Carolina Statewide Standing Order

North Carolina provides robust authority for pharmacists to test and treat influenza and streptococcal infections under a statewide standing order.

The Protocol: To legally prescribe, you must:

Follow the North Carolina Statewide Standing Order.
Perform CLIA-waived rapid diagnostic testing.
Document the clinical encounter and treatment decision.

⚠️ Key Point: The statewide standing order streamlines practice—no individual CPA required for basic Test & Treat services.

The Workflow:

Test: Perform a CLIA-waived rapid test.
Evaluate: Assess symptoms and patient history.
Treat: If positive, prescribe appropriate therapy per the standing order.

2. Hormonal Contraception Authority

The Law: North Carolina Training Requirement

In North Carolina, pharmacists can furnish hormonal contraception after completing required training. This includes oral contraceptives, patches, and vaginal rings.

The Protocol: To legally prescribe, you must:

Complete Board-approved training on contraceptive counseling.
Use a standardized screening questionnaire.
Document the patient encounter and assessment.

Revenue Potential:

Consult Fee: $35-50 (Cash) or CPT 99202 (Medicaid).
Product: Standard dispensing margin.

3. HIV PrEP Authority

The Law: PEP/PrEP Protocol

North Carolina pharmacists have authority to initiate HIV PrEP therapy, making preventive care more accessible across the state.

Requirements:

Follow the statewide PEP/PrEP protocol.
Perform baseline HIV testing.
Provide appropriate follow-up referrals.

Rx Agent Tip: PrEP authority positions your pharmacy as a key player in public health initiatives and opens new revenue streams.

4. How to Bill for Services in North Carolina

It is not enough to do the work; you must get paid.

Medicaid Enrollment: To bill NC Medicaid for CPT codes (like 99202, 99212), you must enroll as an Ordering/Referring Provider.

Portal Link: NC Medicaid Provider Enrollment

Commercial Payers: Most commercial plans in North Carolina are beginning to recognize pharmacists as providers. We recommend billing the patient a cash "Consult Fee" and providing a Superbill using the codes above.

Compliance Checklist for North Carolina

Before you write your first prescription, ensure you have these documents on file:

NPI Type 1: Do you have an individual NPI? (Type 2 is for the pharmacy).
Training Certificates: Have you completed required training for each service?
Liability Insurance: Does your policy cover "Prescribing" or just "Dispensing"?
CLIA Waiver: Is your pharmacy registered as a laboratory?
Standing Orders: Do you have the statewide standing orders on file?

Need the Official Protocols?

Stop searching through the North Carolina Board of Pharmacy website.

Rx Agent has the official, up-to-date Protocols and Standing Orders for North Carolina built right into the chat.

Ask Rx Agent:

"What training is required for contraception authority in North Carolina?"

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